A Lesson in Covering Pseudoscience

Paul Fidalgo alerted me to two interesting takes on a recent meta-analysis of acupuncture research. The research wanted to know if there was evidence supporting acupuncture’s usage over no acupuncture and “fake” acupuncture.

Let’s see what the Associated Press said about the research in its opening paragraph:

Acupuncture gets a thumbs-up for helping relieve pain from chronic headaches, backaches and arthritis in a review of more than two dozen studies — the latest analysis of an often-studied therapy that has as many fans as critics.

And now The Guardian (UK):

Acupuncture could be a useful treatment in some cases of chronic pain, according to a study that pooled the results of 29 clinical trials on almost 18,000 people. But the overall benefits were small, compared with no acupuncture or sham acupuncture.

I’m not talking about the actual results here. You can discuss those all you want. I’m just talking about the media’s coverage of it. The Guardian is quick to point out that any benefits are minimal at best, while the AP appears to celebrate its amazing power. (To the AP’s credit, they eventually get a soundbyte from Dr. Stephen Barrett of Quackwatch.)

To what do you attribute the differences?

About Hemant Mehta

Hemant Mehta is the chair of Foundation Beyond Belief and a high school math teacher in the suburbs of Chicago. He began writing the Friendly Atheist blog in 2006. His latest book is called The Young Atheist's Survival Guide.

  • Tony Miller

    In the US we are always looking for the quick solution and alternative to traditional medication due to our healthcare system. Anything that can be shown as effective (even .01%) will be touted as a solution that will not require insurance and doctor bills.

  • Randomfactor

    “To what do you attribute the differences?”

    The UK still has journalists.

  • Todd Libasci

    Clearly, the Guardian needs to unblock their Qi.

    • cipher

       HEH!

  • machintelligence
  • http://www.facebook.com/profile.php?id=700851737 Sam Kay

    Another thing to consider is what the effect size would be for traditional medicine. Saying that the benefits of acupuncture over no acupuncture or sham acupuncture doesn’t mean anything unless we know what the measuring stick looks like. Let’s say we have a 10-point pain scale. If traditional medication reduces pain by 1 point and has side effects, while acupuncture reduces pain by .5 points but has no side effects, maybe acupuncture is worthwhile after all. Furthermore, if there is a difference between acupuncture and sham acupuncture (sham acupuncture is effectively a placebo in this case), then acupuncture DOES work and warrants research. Maybe if it was moved from fringe to mainstream medicine, we could improve its efficacy through better research.

    • Randomfactor

       But first to settle the question:  beyond anecdotal and highly subjective reports, does it blipping WORK?

    • http://www.holytape.etsy.com Holytape

      All the studies I have seen show no noticeable difference between sham and real acupuncture.  As long as people think they see the needle or feel it, it works. 

      http://archinte.jamanetwork.com/article.aspx?articleid=413107 

  • http://www.facebook.com/profile.php?id=700851737 Sam Kay

    We should also look into the true mechanism of action–because I doubt it has anything to do with unblocking energy pathways.

    • Reginald Selkirk

       Before putting effort into studying how it works, we should first figure out whether it works. I suspect it ‘works’ by unclogging the placebo pathways.

      • Intelligent Donkey

         “we should first figure out whether it works”

        No, because of the placebo effect. Pseudoscience, like acupuncture, chiropractic and homeopathy does indeed work, there’s no question about it. But it’s mostly (if not all) due to placebo.

        I don’t care if it works. If the mechanism isn’t understood, then it shouldn’t legally be an option.

        Death works! It cures everything!

        • http://squeakysoapbox.com/ Rich Wilson

          Just think of the R&D costs would could save if we just re-branded things 
          http://thenextweb.com/shareables/2012/09/13/what-happens-give-people-iphone-4s-tell-its-iphone-5-video/

        • Pisk_A_Dausen

          “I don’t care if it works. If the mechanism isn’t understood, then it shouldn’t legally be an option.”

          The mechanism of anesthetics isn’t fully understood, AFAIK. Lots of theories, both outdated and modern, but little certain knowledge apart from the knowledge that… it works.

    • http://pulse.yahoo.com/_6OE7LEYELE4MZTVXGZUSVTBFUI julie

      I’ve never tried it, but I’m pretty sure it has to do with pressure points — as in, putting pressure on different parts of your body has calming effects.
      Pressure points aren’t complete bullshit. If you lightly squeeze the webbing between your thumb and your finger it will help keep you from crying in a stressful situation. I cry very easily and this has a noticeable effect. There are also some that are supposed to help with nausea and mild pain relief, but I’ve never tried.
      It’s probably that, combined with a bit of a placebo effect. I know acupuncture would not work on me because I’m too scared of needles and would get stressed out. People who are really open to this sort of thing would be more relaxed and would probably benefit psychologically and it would make them think they had benefited physically.

      • http://www.holytape.etsy.com Holytape

        It’s a type of placebo effect.  If you convinced someone that pinching the end of your pinkie would do the same, then it would have the same effect.   It’s why acupuncture does better than no acupuncture, but it is indistinguishable from shame acupuncture. 

  • http://www.facebook.com/profile.php?id=1351473675 Matthew Baker

    We Americans love Woo. We also hold to the strange mix of wanting every story to be balanced (even if there is no credible side to balance a story) and  yet the same story has to offend no one. Woo fans will write nasty Abraham Simpson style letters to the editor sighting personal anecdote as if it was Gospel if their flavor of woo gets questioned in an article. I think writers and editors might often work towards avoiding those results.      

  • http://friendlyatheist.com Richard Wade

    To what do you attribute the differences?

    Perhaps the AP writer or editor goes to an acupuncturist, or his/her spouse does, while that is not the case with the Guardian’s writer or editor.

  • RebeccaSparks

    I would think it’s the journalist writing the article.  Because I found it interesting, I looked up a few more, and found a greater variation on if acupuncture works (vs being a placebo) and how much more effective it is over sham placebo.  AP is actually on the skeptical side:

    With a slightly bigger sample size, It seems that  there 

    by Lindsey Tanner, Associated Press (quoted above)

    “Some believe its only powers are a psychological, placebo effect. But some doctors believe even if that’s the explanation for acupuncture’s effectiveness, there’s no reason not to offer it if it makes people feel better.
    The new analysis examined 29 studies involving almost 18,000 adults. The researchers concluded that the needle remedy worked better than usual pain treatment and slightly better than fake acupuncture.”

    Acupuncture Pain Relief Is Real, Researchers Say
    By Matt McMillen Reviewed by Louise Chang, MD 
    WebMD Health News

    “Now a new study shows the relief they get may be modest — but real….According to the study, acupuncture showed a small but noteworthy advantage over sham acupuncture.”

    http://www.webmd.com/pain-management/news/20120910/acupuncture-pain-relief

    Acupuncture May Offer Real Relief for Chronic Pain
    By ALICE PARK
    Time Magazine Healthland

    “Some people swear that regular sessions of acupuncture help relieve their back pain and headaches. And now there’s evidence they may be right….
    The result was a clear and “robust” effect of acupuncture in relieving chronic pain in the back, neck and shoulders, as well as pain due to osteoarthritis and headaches, Vickers’ team found.”

    http://healthland.time.com/2012/09/11/acupuncture-may-help-reduce-chronic-pain-after-all/

    Acupuncture Provides True Pain Relief in Study
    By ANAHAD O’CONNOR
    New York Times – well
    “A new study of acupuncture — the most rigorous and detailed analysis of the treatment to date — found that it can ease migraines and arthritis and other forms of chronic pain.
    The researchers, who published their results in Archives of Internal Medicine, found that acupuncture outperformed sham treatments and standard care when used by people suffering from osteoarthritis, migraines and chronic back, neck and shoulder pain.”

  • Guest

    The difference is that the Guardian quote is somewhat inaccurate. The difference found between “real” and “sham” acupuncture was small, the difference between acupuncture and other regular  therapies or no therapies was significant.  The AP notes that because acupuncture outperformed other therapies and no care so it should be worth using.  Most of the acupuncture detractors grasp tightly to the issue of placebo control. Placebo control is the gold standard of pharmaceutical research, but not necessarily appropriate for manual therapies like acupuncture.  The only thing we can say for sure about acupuncture is that we don’t fully understand how it works and more research is needed to uncover it’s mechanisms. 

    • Revyloution

      “The only thing we can say for sure about acupuncture is that we don’t fully understand IF it works..”
      FTFY

    • MV

      We fully understand how it works.  It doesn’t.  There is no scientific plausible way for it to work.  There is no chi, there are no energy fields. 

      If it worked, there would be a difference between sham and not sham.

      There is, however, an “effect” from being treated.  However, as this requires misleading patients, it isn’t exactly ethical to treat them under the doctor-patient relationship.  That’s the whole problem with harnessing a placebo.

    • https://twitter.com/#!/OffensivAtheist bismarket

       After it being used for thousands of years, we STILL don’t know how it works? If we haven’t figured it out by now, my guess is that it doesn’t work at all.☮

      • Intelligent Donkey

        I’m very impressed that they managed to make so amazingly thin needles thousands of years ago.

        Or did they? Because if not, then today’s acupuncture is indeed not thousands of years old.

        • Pisk_A_Dausen

          Or maybe they used thicker needles. If it just needs to be thin and sharp enough to pierce skin, I could whittle one, and both knives and trees have been around for a while. (As have needles for various uses.)

  • Reginald Selkirk

    First thing to note is that this is a meta study. They didn’t do any actual trials, they just compiled the data of several previous studies. GIGO is a good thing to keep in mind.

  • Michael Brice

    Hi,

    just wondering if any of the authors of the various posts have had acupuncture, if so why, how many times and the outcome?

    thanks

    • Revyloution

      I had acupuncture for a year.  It was supposed to help me with chronic hand pain.  Over the course of the year, the pain would come and go (like it always did)  After a full year of treatment, I didn’t have any noticeable improvement. 

      • Robster

        Me too. Gave it a shot when I developed type 1 diabetes 33 years ago. My parents paid a fortune, but it was a waste. The quack advertised his service as a “cure”. No longer.

    • http://squeakysoapbox.com/ Rich Wilson

      Because anecdotal evidence is better than an actual double blind study with a control group?

      • http://squeakysoapbox.com/ Rich Wilson

        (not sure how you do double blind with acupuncture, but the point remains)

        • Shawn

          Edzard Ernst has developed  (or is still developing) some needles that retract into the handle, like a stage knife, to be used with a plastic stand that makes the needle stand up regardless of whether or not it’s gone into the skin.  I suspect it will never be perfect though.  Maybe a robot hand, like some surgeons are using?

    • Pisk_A_Dausen

      Weekly for a year to treat incontinence. Didn’t work.

    • cipher

      I had it on and off for Chronic Fatigue. Didn’t do a damn thing for me – but I didn’t keep it up for very long. A friend was doing it gratis and I felt I couldn’t take advantage – and I couldn’t afford to go to a stranger for a long series of treatments.

      This is one of the problems with a lot of alternative medicine. The effects are, supposedly, subtle and cumulative, so you have to keep it up for long periods in order for it to be effective – and insurance doesn’t cover it. It’s hard enough to get insurance to cover conventional medical treatment these days.

  • Mike Laing

    The US Association of AltMed Scambuckets advertises with Associated press, would be my guess

  • A3Kr0n

    I for one do not like the idea of someone sticking long needles into my nerves, or close to my nerves, or just plain sticking long needles into me period. My only exception is the dentist, but she uses novacaine.

    • MV

      Geez, what could possibly go wrong with using needles without the proper sterile technique? 

  • Kimpatsu

    “To what do you attribute the differences?”
    Ben Goldacre writes for the Grauniad.

    • Sindigo

      This.

  • JohnnieCanuck

    Maybe it only cures pain in people who are masochists and get pleasure from the endorphins released by the pain of the needles. Oh, wait… Never mind.


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